Background Distal biceps tendon ruptures can lead to significant restrictions in affected patients. The mechanisms of injury described in scientific literature are based exclusively on case reports and theoretical models. This study aimed to determine the position of the upper extremities and forces involved in tendon rupture through analyzing video recordings. Methods The public YouTube.com database was queried for videos capturing a clear view of a distal biceps tendon rupture. Two orthopedic surgeons independently assessed the videos for the activity that led to the rupture, the arm position at the time of injury and the forces imposed on the elbow joint. Results Fifty-six video segments of a distal biceps rupture were included (55 male). In 96.4%, the distal biceps tendon ruptured with the forearm supinated and the elbow isometrically extended (non-dynamic muscle engagement) (71.4%) or slightly flexed (24%). The most common shoulder positions were adduction (85.7%) and neutral position with respect to rotation (92.9%). Most frequently a tensile force was enacted on the elbow (92.9%) and the most common activity observed was deadlifting (71.4%). Conclusion Distal biceps tendon ruptures were most commonly observed in weightlifting with a slightly flexed or isometrically extended elbow and forearm supination. These observations may provide useful information for sports specific evidence-based injury prevention, particularly in high performing athletes and individuals engaged in resistance training. Level of evidence Observational study.

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Partial rotator cuff tears are the most common pathology of the shoulder joint. Diagnostic of such conditions is a challenging problem for trauma surgeon.Purpose of the study is to analyze the diagnostic significance of manual tests and the standard MRI of the shoulder joint.Materials and Methods. The study is a retrospective analysis of disease history data of 25 patients (15 males, 10 females) treated at the authors’ hospital during the period from 2014 to 2017. Examination was performed according to a standard protocol: assessment of shoulder range of motion, palpation, manual examination, including “full/empty can” test, a painful arc symptom and the Hawkins – Kennedy test. All patients underwent MRI of the shoulder joint. The mean age of patients was 50.8 years. Shoulder joint arthroscopic inspection was considered the gold standard for diagnostics.Results. After data analysis, the following results were obtained: sensitivity of the “full can” test was 68%, the accuracy was 68%; “empty can” test sensitivity and accuracy were 76%, respectively. MRI sensitivity for diagnostics of supraspinatus tendon ruptures was 84% with the accuracy of 84%. The combination of the Hawkins – Kennedy test with the symptom of painful arch demonstrated accuracy and sensitivity of 64%. The study evaluated the effectiveness of MRI for diagnostic of the rupture type: sensitivity for injury from the joint surface — 80%, from the subacromial space — 70%; specificity for ruptures from the articular surface — 90% and from the subacromial space — 93%. The accuracy was 84% for both types of ruptures.Conclusions. Combined application of manual tests and MRI of the shoulder joint allows to diagnose partial rotator cuff tears in the majority of cases.

Calcific tendinitis of the rotator cuff is a common disorder and can be successfully treated with non-operative techniques in most cases, although surgical management should be considered in some patients for adequate calcium removal. No clear consensus exists regarding whether the involved tendinous portion to be repaired or not with suture following the deposit removal. The purpose of this study is to evaluate and compare results of re-fixation and debridement of the rotator cuff tendons after calcium removal. Material and methods The study is a retrospective analysis of case histories, operation protocols, magnetic resonance images and radiographs of the shoulder of 19 consecutive patients diagnosed with calcific tendinitis that was surgically treated at our clinic between 2013 and 2016. The median age of the patients was 52 years. All patients were divided into two groups depending on the surgical treatment performed. Calcium deposit was removed and the rotator cuff sutured in patients of the main group, and calcium was removed and the rotator cuff debrided in controls. Results Outcomes were rated as excellent with OSS in 58.3 %, as good in 33.3 % and satisfactory in 8.4 % of the patients in the main group. Controls showed 28.6 % of excellent outcomes and 71.4 % of good results. Excellent ASES shoulder scores were recorded in 91.6 % of the patients in the main group and 8.4 % had satisfactory results. Excellent results were achieved in 71.4 % of controls and 28.6 % had good results. No poor outcomes were observed in the patients. No statistically significant differences were found between the groups. All patients of the main group completely regained the function up to 100 % at a follow-up visit. However, the median time required to regain function by 50 % was 3 months (interquartile range 2:6) after surgery in patients of the main group and 1.5 months in controls. There was a correlation revealed between persistent history of calcific tendinitis and dimensions of the deposit according to the Bosworth classification. Conclusion A type of calcium deposit identified with radiological classifications was shown to have no impact on outcomes. Patients who underwent no repair of the rotator cuff achieved 50 % recovery of the shoulder function almost twice as quickly as those with repaired tendon. No statistically significant differences in outcomes were found between the groups but patients of the main group showed higher scores measured with patient-reported outcomes. More research needs to be carried out on a variety of techniques before definitive conclusions can be made on strategies of surgical treatment of calcific tendonitis.